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General NPI Number Information
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NPI Number | 1255008181
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Entity Type | Individual
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Provider Name | KALEY MCCANN NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 1355 HINCKLEY DRIVE
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City | OGDEN
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State | UT
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Zip | 84401
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Country | US
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Telephone | 801-387-6150
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Fax |
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Provider Business Mailing Address
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Address Line | 3404 ECCLES AVE
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City | OGDEN
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State | UT
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Zip | 84403-1216
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Country | US
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Telephone | 208-243-1371
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10444865-4405
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License Number State | UT
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